Early-Term Results of Endovenous Saphenous Vein Radiofrequency Ablation Combination with Trans-sheath Ultrasound-Guided Foam Sclerotherapy

Objective: To determine the early success rate in cases of great saphenous vein insufficiency treated with radiofrequency ablation (RFA) and combined transsheath ultrasonography-guided foam sclerotherapy (RFA+ST). Study Design: Descriptive study. Place and Duration of the Study: Department of Cardiovascular Surgery, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkiye, from July 2022 to October 2024. Methodology: Patients who underwent only RFA and combined RFA+ST between July 2022 and October 2024 were retrospectively scanned. Demographic data and complications were recorded. Differences between the demographic and collected data of the two groups were examined using the Mann-Whitney U test, Pearson's Chi-square or Fisher's exact test. Results: In total, 235 patients were included in the study: 120 in the RFA group (Group A) and 115 in the RFA+ST group (Group B). The median age (IQR) of Groups A and B was 48 (24) and 50 (26) years, respectively. The gender distribution was 86 females (65.6%) and 45 males (34.4%) in Group A, 75 females (67%) and 37 males (33%) in Group B. The median GSV diameter was 6.7 (1.5) mm and 7 (1.7) mm, respectively. Recanalisation occurred in 8 (6.1%) patients in Group A and 1 (0.9%) patient in Group B (p = 0.041). Other complications in Groups A and B included tenderness [7 (5.3%) vs. 12 (10.7%)], phlebitis or cellulitis [4 (3.1%) vs. 2 (1.8%)], ecchymosis [1 (0.8%) vs. 2 (1.8%)], hyperpigmentation [5 (3.8%) vs. 2 (1.8%)], and phlebothrombosis [7 (5.3%) vs. 24 (21.4%); p <0.001], respectively. Conclusion: In Group B combined with foam sclerotherapy, recanalisation rate was found to be significantly lower, and phlebothrombosis was higher in the early period. Closure reactions may develop more strongly with phlebothrombosis; however, appropriate case selection and procedure should be performed very carefully due to possible adverse conditions such as deep vein thrombosis.